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Fig 4: Preoperative status: fractured #11 Fig 5: Preoperative status: fractured #11

Fig 6: Firm, unrestorable #11 Fig 7: The first sectioning Fig 8: Remove the palatal portion with the
apex

Fig 9: Verify residual Fig 10: Preparing the shield. Reduce the shield to Fig 11: Final shield prep with internal bevelling
endodontic filling the crest of the bone
material removal

Evaluate the tooth trajectory using CBCT imaging. Step 3: Palatal root extraction
Utilize a peeso reamer to follow the root canal anatomy to the apex, Luxate and remove the palatal portion of the root carefully.
confirming the depth radiographically. Avoid forcing the luxator between the labial and palatal portions, as
If the coronal tooth structure is intact, perform decoronation this may compromise the stability of the labial fragment.
before proceeding to the apical preparation. Confirm complete apical root removal radiographically.

Step 2: Root sectioning Step 4: Root canal content removal
Using a long-shank carbide bur, section the root mesiodistally, Using a long-shank round bur, eliminate all the residual endodontic
ensuring a clean separation between the labial and palatal portions. material.
Maintain care to avoid damage to the interproximal bone, especially Confirm the thoroughness of cleaning through radiographic
at the apical region. evaluation.

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Dental Practice I March-April 2025 I Vol 21 No 2 13